臍部単孔式腹腔鏡下胆囊摘出術―スポンジチューブの有用性―

Single port laparoscopic cholecystectomy : effectiveness of the sponge tube technique

◆要旨：臍部単孔式腹腔鏡下胆囊摘出術（以下，SPS）は，手術創が目立たず整容的で，術後疼痛の軽減，入院期間の短縮に有効である．当科では，臍部に1.5cmの縦切開を行い，創にスポンジチューブを3本挿入し，チューブ内にそれぞれ5mmトロッカーを挿入する．スポンジチューブの使用は，低コストで，気腹ガスの漏出防止，創の保護，鉗子操作性の向上に有効である．胆囊底部をミニループリトラクターで把持し，右手に先端屈曲型把持鉗子，左手に電極付洗浄・吸引器を用いて通常とは逆手で操作を行う．平均手術時間は53.0分，平均在日数は2.8日で術後経過良好であった．この手技は安全で利点も多く，非常に有用であると考える．

　Single port laparoscopic surgery（SPS）is a cosmetically-good surgical technique. It's advantages are invisible incision, mininal wound pain and short hospitalization. We make an incision of 2 cm in the umbilical region, and insert the three sponge tube and three 5 mm sized trocars. The use of the sponge tube is good for lowering costs, and it is effective for the prevention of the pneumoperitoneum gas leakage and the improvement of the operation performance of forceps. The gallbladder is held by a mini-loop-retractor. The operator uses a holding forceps in the right hand, a electrosurgical knife with a washing and suction apparatus in the left hand. Median operative time was 53 min and median length of postoperative stay was 2.8 days. The data for patients undergoing single port laparoscopic cholecystectomy was not different from patients undergoing standard（multiport, multi-incision）laparoscopic cholecystectomy. We thought that this operation method is a safe surgical technique with many advantages.